Peter Parker is a 6 year old boy you are caring for on the ward post an adenotonsillectomy.
You are completing your post anaesthetic observations and you need to assess his pain level. What pain assessment tool will you use?
You could use 2 - Face pain Scale or FLACC
You check your 6 rights of drug administration, then Peter asks “Is it Orange flavour, I only like Orange flavour, I’m not having it if it’s not Orange”
You state its Strawberry flavour- Peter refuses to take it- What will you do?
- Encourage Peter
- use reward charts
What does C.U.S stand for?
C-concerned
U-uncomfortable
S-safety Issues
How a nurse should go about dealing with medication issues.
Example:
Doctor I’m concerned about giving a dose that is higher than the recommended range in an opioid sensitive patient. I am uncomfortable with administering a dose that is higher than the recommended range as it would be classified as a medication error. I feel that giving a higher than recommended dose to the patient 4 hourly is a safety issue for the child
Sarah-Jane Smith is a 3 year old who you are caring for post dental extraction x 5.
She is crying and distressed arching her back and wont settle with her mum.
What pain tool will you use to assess her pain?
FLACC tool
What are the benefits of providing family centred care?
Involve the family in the process
Provides feelings of control
Prepares family for care required at home
Reduces emotional stress & anxiety
Promotes feelings of value, worth, and competence to care for their child
Promote trust of nursing staff- feeling fully informed
List some strategies to help the child cope with procedure
- Children need explanations*- clear & simple NO MEDICAL JARGON!
- Lots of reassurance
- Keep the caregiver present*
- Caregiver isn’t always present – sometimes it’s better to use them as comfort after so the child doesn’t associate them with the procedure
- No painful procedures in their sleeping/play area- use treatment room when able
what is pain?
An unpleasant sensory and emotional experience with actual or potential tissue damage. Pain is always subjective. Each individual learns the application of the word through experiences related to injury in early life”
What is QUESTT?
Used to assess the child pain. Q=Question the child U=Use a pain rating scale E=Evaluate the behaviour and physiological changes S=Secure parents involvement T=Take cause of pain into account T=Take action & evaluate results
How do we assess neonates pain?
PIPP Pain Assessment tool used
what do we use oral sucrose for and what does it do?
- oral sucrose can be used for procedural pain relief
-The sweet taste of sucrose causes release of endogenous opioids
However it has been shown not to be effective when given straight into the stomach
What pain assessment tool do we use for a child or infant age between 0-23 months?
- CHIPPS = Children and Infant Postoperative Pain Scale
- FLACC= Face, Legs, Activity, Cry, Consolability (can be used for most age groups)
What pain assessment tools might we use on an adolescent?
-VAS= Visual Analog Scale
-Numerical Pain Intensity Scale
however always ensure that these have been well explain to them to ensure they understand what is being asked.
What pain assessment tools might we use in a non-verbal disabled child?
VIDATAK EZ Picture Board
List ways in which we can provide pain management to a child
- Pharmacological - Medications
- Non-pharmacological – heat packs, cold packs, position change
- Environmental – Room temp & lighting ?sharing with another child – works well for some but not all
- Psychological – Family, diversion therapy
List some non-pharmacological pain management
- Guided imagery
- Comfort toy
- Heat/ice therapy
- Play
- Music Therapy
- Dummy
- Cot mobiles
- IPAD games!
- Pictures
- Games
- Dog therapy
- Positive reinforcement
- Breathing/Meditation
